Managing Asthma

You know that exposure to your asthma triggers brings on increased inflammation and tightening of your airways. This results in coughing, wheezing, buildup of more mucus, chest tightness, or shortness of breath. Early warning signs can begin quite a while before an actual asthma attack. Have you noticed that you feel any differently within the days before an flare-up of your asthma? Within a few hours before an asthma attack? A few minutes before? Warning signs are different for every person and also vary in each situation. However, some people do not notice any warning signs before an asthma attack.

If triggers and symptoms are not controlled well, your asthma continues to flare up and you start to feel worse. This can happen suddenly or gradually over time. These symptoms can escalate to a point that your breathing is so difficult that you are in a medical emergency. Asthma attacks can be serious, but you can take some practical steps to reduce them.

Monitoring Airway Changes

Trigger management includes monitoring your airways in order to anticipate and prevent asthma attacks. Triggers cause changes in your airways before asthma symptoms act up. This can be days, hours, or even minutes before you experience any symptoms. Everyone is different. Knowing your typical pattern for triggers and symptoms helps you to predict and manage asthma attacks. You can take the following practical steps to help reduce the chance of an asthma attack and to recognize a developing asthma attack.

1. Monitor changes in your airways using your peak flow meter.
2. Keep track of your symptoms in an asthma diary.
3. Know the early signs of an asthma attack and follow your Asthma Action Plan.
4. Manage your triggers.

Using Peak Flow to Monitor Airways

Follow peak flow monitoring instructions in your Asthma Action Plan. Know what your personal best reading is and how well your controller medicine is working. Record your readings in your Asthma Diary. After exposure to one of your known triggers, use your peak flow meter to monitor changes. The sooner you find out that your asthma has been triggered and how your airways are reacting, the quicker you can take action to prevent or end a flare-up. Your Asthma Action Plan links your peak flow readings and associated symptoms with important action steps. Peak flow readings fall before and during an asthma attack, when airway inflammation and tightening increase. This drop can happen before you feel any symptoms. Be the "air-traffic director" for your asthma and try to keep all systems go.

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Written by Karen Serrano, MD
Emergency Medicine resident at the University of Wisconsin-Madison.

Reviewed by Lisa V. Suffian, MD
Instructor of Clinical Pediatrics in the Division of Allergy and Pulmonary Medicine at Saint Louis Children's Hospital, Washington University School of Medicine
Assistant Clinical Professor in the Department of Pediatrics at Cardinal Glennon Children's Hospital, Saint Louis University
Board certified in Allergy and Immunology

Last updated June 2008